Harry Edward Gray III, O.D., PH.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5212 Issued in OH

Practice address

5100 Great Northern Mall
JC Penney Optical
North Olmsted, OH 44070-3305

Phone

(440) 779-8145

Fax

(440) 779-9118

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Usv Optical Inc.

  • Eyewear Supplier
  • North Olmsted, OH
  • NPI 1801801626
  NPD (past)
• Usv Optical Inc

  • Eyewear Supplier
  • Blackwood, NJ
  • NPI 1578891008

  Optometrist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033257019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 LOWRIE BLVD",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440671272",
            "telephone_number": "330-467-0255",
            "fax_number": "330-467-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 GREAT NORTHERN MALL",
            "address_2": "JC PENNEY OPTICAL",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703305",
            "telephone_number": "440-779-8145",
            "fax_number": "440-779-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "HARRY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2274462",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Gorman
• Cassidy Alexandria Gould
• Darrel Grady, LPN
• Ellis Martinez Graham Jr.
• Carmen D Gray
• Carolyn Green
• Jordan Green
• Caitlyn Marie Greene, LPN
• Gregory X Boehm, M.D. LLC
• Isabelita E Guadiz, MD

• Optometrist in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.